Once-daily radiotherapy is not superior to twice-daily treatment for patients with small-cell lung cancer (SCLC) receiving concurrent chemoradiotherapy, according to a study published in The Lancet Oncology.1

SCLC, which is highly aggressive even from an early stage and carries a poor prognosis, tends to respond to concurrent chemoradiotherapy. Although radiation is typically administered in 2 daily doses, researchers hypothesized that once-daily higher-dose radiotherapy would improve outcomes in this setting.

Patients in both groups received concurrent cisplatin-etoposide for 4 or 6 cycles.

Of 274 and 273 patients assigned to receive twice-daily and once-daily chemoradiotherapy, respectively, 249 and 240 underwent concurrent treatment. Almost all initially assigned patients were, however, included in the survival analysis.

Patient characteristics were similar in the 2 groups: in the twice-daily group and the once-daily group, respectively, median age was 62 and 63 years, 96% and 97% of patients were Caucasian, and 98% and 99% of patients were former or current smokers.

Toxicity was similar in both groups, though grade 4 neutropenia was more common in the twice-daily group. There were 3 treatment-related deaths in the twice-daily group and 8 in the once-daily group.

The authors concluded that “from a pragmatic perspective, once-daily radiotherapy could be considered when delivery of twice-daily radiotherapy is impossible because of departmental logistics or patient choice.”